How to Achieve Time Freedom with Remote Services: Insights from Joe Camoratto
Join us during our latest DPT to CEO interview where I sit down with Dr. Joe Camoratto, PT, owner of Across the Continuum where he helps cash based practice owners implement remote strength and conditioning programs for their clients.
We dive into Joe’s journey—how he got to where he is now—and chat about why he’s so passionate about strength and conditioning as a cornerstone of lasting wellness. We also discuss why PTs are uniquely qualified to provide this type of care. Joe’s insights and hard-earned lessons are a must-hear for any practice owner looking to build a fulfilling business for the long-haul.
What we're covering:
Joe, if you don't mind, share a little bit with us about what you got you to where you are today.
Joe: My name is Joe. I’m a doctor of physical therapy, 6'3", and 32 years old. I've been a physical therapist for eight years. I graduated from Duquesne University in Pittsburgh in 2016, and since then, I've navigated nearly every corner of the physical therapy field before finding my place today.
My career began working for the military right out of school in California, then moved to Mississippi where I continued working in a military clinic. That was my first experience in Mississippi. Next, I joined a private practice, but after a clash with the owner—which involved filing police reports due to physical altercations—I was let go. That marked my second clinic experience. I then took a position in wound care at a local hospital (my third PT job) and later worked as a travel physical therapist in rural Louisiana (job four). I was fired there too, supposedly for being "too sarcastic," which doesn’t sound like me! Following that, I did some PRN work at an inpatient facility, then returned to the military as a clinical instructor, teaching both inpatient and outpatient care. That brought me to jobs five and six. I also spent time in home health, and once again worked in a military setting, this time in New Jersey, completing seven or eight positions over my six years in the clinical world.
Throughout these roles, I struggled to find a clinic that embraced strength and conditioning as a frontline intervention in physical therapy, which I believe is key to effective care. Eventually, after my seventh physical therapy position, I started a mentorship with my good friend, CJ DePalma. Together, we set out to bridge the gap in strength and conditioning within the physical therapy space. To that end, I created the Clinical Coach Challenge, a six-week program to teach physical therapists about periodization, athlete management, and strength and conditioning. However, it didn’t take off as I’d hoped. It seemed the PT community wasn’t receptive, perhaps believing that current interventions were enough, as patients often improve given time and support.
Despite this setback, I found success in a different direction. The mentorship group that helped promote my strength and conditioning program had an audience highly interested in my remote work experience. I was working exclusively in remote athlete management with a company called WODPrep, a CrossFit programming organization. People wanted to learn more about that, so I developed my current program, Remote Wellness Fast Track. This program teaches physical therapists who own cash practices how to incorporate remote strength and conditioning into their business model.
It’s been a long road, filled with challenges, tears, and failures. But things are finally falling into place, and people seem to appreciate what I’m offering. So, for now, I’m here to stay.
Tell us a little bit more about what it was like to work for the government.
Joe: My last clinical position was at Travis Air Force Base, where I received Department of Defense (DOD) training. This training opened doors for me to do contract work as a physical therapist for the military. I went on to work as a contract physical therapist for the Air Force and Army at Keesler Air Force Base in Mississippi and later at Joint Base McGuire-Dix-Lakehurst in New Jersey, a tri-base installation.
As a contract therapist, you’re hired by the U.S. government specifically to provide physical therapy. It’s a unique setup, as there’s only one payer source, TRICARE, which simplifies things. Plus, there’s plenty of funding available, which means excellent facilities and resources. You get your own office, federal holidays off, and access to some of the best gyms I’ve ever seen in a physical therapy clinic—money is simply not an issue in this setting. Overall, it’s an enjoyable experience, especially considering the advantages you rarely find elsewhere as a physical therapist.
Morgan: Yeah, back when I was in school, I considered going into military physical therapy partly because my dad was in the military too, so it was on my radar. Am I right in thinking that physical therapists in the military generally have more privileges than civilian PTs?
Joe: Yes, military physical therapists do have more privileges, though I’m not sure all of them are necessarily beneficial. As a primary care provider, you can refer patients to other physicians, see patients via direct access, and even prescribe certain medications—mainly things like Tylenol or mild muscle relaxers, provided you have the required training and can demonstrate competence. You’re also permitted to perform dry needling and order imaging, although I’m not entirely convinced these added responsibilities are essential for being an effective physical therapist.
While military PTs have more responsibilities and are held to a higher standard, the biggest advantage is that you typically see just one patient per hour, and they’re generally in good physical shape due to their military background.
Tell us about the work you're doing now.
Joe: I wouldn’t call myself a remote physical therapist, but I teach PTs how to incorporate more remote options into their practice. My main offering is the Remote Wellness Fast Track, an eight-week, one-on-one coaching program. Through this course, I guide PTs on how to sell and integrate remote or online coaching to extend patient retention, improve outcomes, and increase revenue.
During the program, we have weekly calls where I help break down barriers and walk you through my process of integrating online coaching and remote care into both your current and long-term care plans. I also design a workout program for you, so you experience firsthand what a remotely delivered program looks like and the results it can deliver. Additionally, I’ve incorporated content from the Clinical Coach Challenge, creating a comprehensive system that immerses you in strength and conditioning as well as remote coaching practices.
The goal is to support PTs who have a performance-oriented caseload and a busy schedule—those who may be considering hiring help or who struggle to see all their patients in person. I teach them how to transition patients who don’t necessarily require in-person visits to a remotely managed program. This type of program is easy to manage, provides real value to the patient, and frees up time for the PT.
Morgan: From listening to your podcast, I feel like I really connect with your overall philosophy. Correct me if I'm wrong, but my takeaway is that your goal goes beyond just relieving pain. It sounds like you're promoting a focus on long-term health, wellness, and fitness for patients. Rather than simply taking someone from severe shoulder pain to being pain-free, you aim to help them achieve overall, lasting health.
Do you work with practice owners that are already exercise based?
Joe: I understand that we need to keep the lights on and that passive modalities have their place at times. I’ve discussed at length the mechanisms and efficacy behind why certain interventions work, and while there’s a lot to unpack there, I get that these approaches are sometimes necessary.
However, I’ve found that clinicians who focus heavily on passive treatments often lack the conviction to position exercise at the value it truly deserves—often hundreds of dollars per month. If charging $400 monthly for basic strength and conditioning programming seems outrageous to someone, then this approach may not align with their practice. Without a firm belief in exercise as a core component of care, it’s challenging to confidently suggest that patients commit to long-term, active programming after several sessions of, say, dry needling or other passive treatments.
My question to these clinicians is: as a physical therapist and a doctor in your field, you understand the utility of exercise—so why not incorporate it more fully into your practice? In my experience, PTs who aren’t already integrating strength and conditioning, even as a secondary intervention, face an uphill battle. If it was truly a priority, you’d see some evidence of it in their practice—a squat rack, a focus on functional movement, or some form of active treatment already in place. And if that’s not their philosophy, that’s okay too.
Morgan: So you’re saying that if someone is currently more focused on manual modalities or hands-on therapy, but they’re at least using some exercise or open to adding it to their practice, then this approach could absolutely work for them.
How do you start implementing and selling a remote strength and conditioning service?
Joe: I refer to this as "expectation touch points." My recommendation is to start as early as possible—reach out to your referral sources and let them know about the new services you're offering, so they can pass that information on to patients when referring them to you. There should also be a narrative about this on your website. Include it in the phases you outline on your site; for example, Phase 3 could be "Remote Wellness," highlighting how patients will be able to do their training right from their phones without having to come into the clinic.
It's important to show them a roadmap from the first evaluation or in a pre-appointment email, so patients know what to expect and where they’re headed. My biggest piece of advice is to start sooner. I recommend that all my clients deliver their Health Programs (HP) remotely using a periodization app like TrueCoach, which we use for our Remote Wellness FasTrack program. This way, patients get used to receiving a remotely delivered program, and they become familiar with the service. The key is to reduce any confusion—uncertainty doesn’t sell. By the end of physical therapy, if patients are still unclear about what you offer, they won’t be interested.
*Find my personal review of TrueCoach in the blog post here.
To avoid that, eliminate the uncertainty from the beginning by introducing them to the remote service early on. You don’t need to give them the full program right away; we use a stepwise approach that offers more or less time from you or more or less skill-based work as patients progress through therapy. The most important thing is to manage expectations from the start. Let them know that after reaching a certain checkpoint in their treatment, they’ll transition to a fully remote program for at least three months to continue their training.
*To learn more about selling your services for cash, check out the blog post here.
Tell me how you approach talking with PTs that don't see strength and conditioning as a skilled service?
Joe: The question often comes down to whether something is considered "skilled" or not, which is where much of the discussion around billing, scope of practice, and insurance lies. Strength and conditioning often gets questioned on this front, and it’s a tough one. My point is, how can we consider something like manual therapy, which is broad and vague, as skilled just because we’re the only ones allowed to do it? I can understand dry needling being considered skilled because of the risks involved, like causing a pneumothorax, but the idea that strength and conditioning isn’t skilled because it doesn’t involve hands-on treatment seems flawed.
When we talk about creating a periodized program that takes into account not just a patient's strength and conditioning goals but also their aches, pains, and how to adjust the program to accommodate those, it becomes clear that there is skill and complexity in this approach. It’s a different kind of skill than the traditional "hands-on" therapy that physical therapists are typically associated with, but it’s no less complex.
Physical therapists are uniquely positioned to manage periodization, programming, and athlete management from a musculoskeletal perspective. Many physical therapists still focus on symptom modification, and while there are plenty of approaches that can "work" in that sense, we need to understand the mechanisms and logistics of the body to know what’s actually beneficial in the long term.
When it comes to periodization, writing a program involves a lot of skill—considering the variables of the patient's musculoskeletal presentation and how to tailor the program to those needs. However, it’s tough because basic treatments, like a 3x10 regimen, often work just as well as more complex programs. People tend to get better from a variety of issues on their own, and it’s hard to convince someone that they need more knowledge than what they’re already using to achieve good symptom relief.
It’s a hard sell, especially when patients get better because the therapist is persuasive, charismatic, or just good at their job. When your patients improve because of your charm or your ability to communicate well, it can be difficult to argue that they should invest time in learning a more complicated approach, like periodization. And I think that’s part of why the Clinical Coach Challenge didn’t take off—it was hard for people to see the value in learning these complicated systems when they were already seeing improvements with their current methods.
Morgan: So to some extent, it’s like, "Why change something that’s not broken?"
Joe: Right, and to almost counter the other point, for those who are heavy on manual therapy, it’s a tough sell. They’ll say, "My manipulations work just fine, and that’s what patients come to me for—to feel better. They’re adults, and they can do whatever they want after I do my job." But the reality is, we can do so much more, and patients will pay more for it. Plus, you’ll need fewer patients to achieve the same results.
What are some of the key things you've learned as a business owner?
Joe: What I've learned is to drastically expand your time horizon for when things will work. It’s easy to think, "This month, it’s going to take off," but after three years, you start to realize you need to manage your expectations. People aren’t always going to like what you’re doing, and you have to be okay with that. If you hold on to something for too long without people supporting it, something will give—it’ll either be your confidence, which can derail everything, or you’ll just run out of steam. So, putting things out there and listening to what people are saying is important.
I never really got behind the idea of blocking haters. Sure, they’re out there, but maybe they have something to say that could help you improve what you're doing. For example, when I was working on something else that wasn’t working, I pitched it to my coach. He suggested a much better idea, and I was open to it. If I had dismissed his input, I’d probably still be stuck in the same place, and it still wouldn’t be working. It’s kind of like applying physical therapy interventions—there are multiple factors at play, and you can’t always isolate them all at once. Sometimes, things aren’t going the way you want, and you have to be okay with that uncertainty.
In business, it could be your marketing, your message, how you’re delivering it, your niche, or your offer. It's tough, and my advice is, it’s hard, and you have to be okay with that. You might come out swinging with a fantastic offer and the ability to focus on just one thing, or you might struggle. Either way, you’re going to face challenges. It wasn’t until I got further into entrepreneurship that I started asking people who had been there. They helped me see where I was going wrong and gave advice like, "Do this, phrase it like this, or don’t waste your time on that."
*Learn more about shifting your mindset as a business owner in the blog post here.
Morgan: I really wanted to talk to you about this because my journey was exactly the same when I started my practice. There were just so many things I wanted to do. I have a lot of passion, and there are so many different ways I want to help people. It’s like, “Okay, you can go down this path, but it’s going to be way harder and take longer.” All of these are great ways to do good things, and I would love to do them all at once, but I know if that’s how you feel, you’re definitely not alone. It will take longer to do everything at once, and some days, I do regret starting out so scattered. But at the same time, there’s a benefit to going through that struggle—it helps you figure out what you truly want to do.
How to contact Joe:
*Website: https://acrossthecontinuum.com/
*Instagram: @acrossthecontinuum
Listen to this episode on my podcast!
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